The reproductive health care safety net is full of holes, tears and patch mismatches. A sharp-eyed inspection shows substantial damages caused by ill-intentioned rips and malicious budget cuts. With a new congressional majority, major repairs can be made by passing two pending federal legislative proposals that have been low profile, but would be high impact.
The 340B Program Improvement and Integrity Act
House Resolution 2606
Representative Bobby Rush, a member of the Congressional Black Caucus, is leading an effort in the Health subcommittee of Energy and Commerce, to expand and improve the 340B program which gives patients of safety-net providers access to low cost drugs, including contraceptives.
The 340B program requires pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at low prices to publicly funded health care agencies that serve uninsured and low-income populations. Representative Rush's bill would require pharmaceutical companies to expand access to the program to include community hospitals, rural referral centers, Maternal and Child Health care providers (e.g. services to children with special health care needs and family planning clinics), as well as mental health and substance abuse centers. Additionally, HR 2606 would tighten up holes in the program by strengthening the Department of Health and Human Services' ability to verify eligibility as well as pricing calculations. The net result: expanded access to drugs by people in need and a projected annual taxpayer savings of $217 million.
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The Unintended Pregnancy Reduction Act
Senate Bill 1075
Over the past five or six years, there has been a quiet and powerful advance in access to reproductive health care from Texas to Wisconsin and from New York to Oregon, providing free reproductive health care for those in need. For preventing unintended pregnancies, sexually transmitted infections, and reducing abortions, there is nothing less expensive or more effective than free access to confidential contraceptives and routine clinical care.
The dramatic change in the scope and shape of the reproductive health care safety net has resulted in Medicaid providing more than half of all federally-funded family planning services received by patients. The simplest reason for that shift is that twenty-six states are operating Medicaid Section 1115 Family Planning Waiver demonstration projects. These demonstration projects have proven their effectiveness in reducing unintended pregnancies as well as their cost-savings (PDF).
Senate Bill 1075, the Unintended Pregnancy Reduction Act, would expand Medicaid funded family planning services to all states and territories and would make renewals of existing waivers much easier. The opportunity to design a program that meets patient needs in rural areas, in underserved areas, and to women and men in need should be available to all states, across the nation. The success is so widely and well documented (PDF) that maintaining their status as "demonstration projects" is an anachronism.
With a reasonably accessible and comprehensive design, these Family Planning Waivers have already been proven to do the following:
- save money
- improve maternal and child health outcomes
- prevent unintended pregnancies
- prevent and treat sexually transmitted infections
- reduce the need for abortions
Three ways to move these bills forward:
- Use the "contact us" link at the House Energy and Commerce Committee Subcommittee on Health's website and the Senate Finance Committee's website. Let the committees know that HR 2606 and S 1075 will expand access to preventive health care and improve maternal and child health outcomes while saving taxpayer dollars.
- Visit the "Write Your Representative" website and the "Find Your Senator" website. Let your own representative and your senators know that you support HR 2606 and S 1075 and that you would like his/her support for these bills as well. Ask for a hearing and a vote.
- Ask friends and organizations who support access to primary care, Maternal and Child Health programs, mental health and drug treatment centers, and community hospitals and clinics to support HR 2606 and S 1075 by making the congressional contacts above and helping you spread the word.